Foster Application Form

How did you hear about Burry Paws Animal Rescue?

Full Name*

First NameLast Name

Age*

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home*

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:*

Do you:*

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Household Setting

RuralSuburbanUrban

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?*

YesNo

Are all members of your Family agreeable to Fostering a Cat?*

YesNo

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Sex, Altered, UTD Vaccines, Heartworm, Living/Deceased)*

Do you have a preference in sex of foster?*

MaleFemaleNo Preference

Are you willing to foster a cat of any age?*

YesNo

If not, what age would you consider?

Are you willing to take your foster cat to vet appointments at a convenient time for you?*

YesNo

Do you drive or have access to a vehicle to bring your foster to events and appointments*

YesNo

If No please explain

Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?*

YesNo

We cannot guarantee a cat to be housebroken, are you equipped to train with love and patience?*

YesNo

Have you had any experience with an emotionally or physically neglected or abused cat?*

YesNo

If Yes please explain

How many hours in a day would the foster be left alone?*

Please list 3 personal references with names, addresses, phone numbers and how related. We prefer it not to be all relatives. Are you ok with this?*

YesNo

Vet Reference: Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #3: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Burry Paws Animal Rescue animal fostered by me. I certify that the above information is correct, and I understand that the information will be verified. I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Burry Paws Animal Rescue and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster cat. I accept full responsibility for the cat(s) actions at all times, and release Burry Paws Animal Rescue from any liabilities or damages that may be incurred because of fostering such cat(s). I agree to have Burry Paws Animal Rescue complete reference call checks and conduct a home visit inspection to be able to approve my foster application. I agree that if I'm unable to foster the cat(s) anymore that I will return the cat(s) to Burry Paws Animal Rescue.

Date*

MonthDayYear

Your name*

E-mail